Currently barriers exist in delivering quality health care. This study aimed to investigate such
barriers in the eight rural district hospitals of the West Coast Winelands Region, three type A
and five type B hospitals.
A quantitative descriptive design was applied which included the total population of nursing
staff (n = 340) working at the time of data collection. A self-administered questionnaire was
distributed with a response rate of 82%.
Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot
study. The validity, specifically construct and content validity, were assured by means of an
extensive literature review, pilot study and use of experts. Ethics approval was obtained from
the relevant stakeholders.
Results showed that 272 participants (97%) disagreed that provision of staff was adequate,
with staff above 40 years of age more likely to disagree (p = <0.01). A statistically significant
association was shown between availability of doctors and staff not being able to cope with
emergencies (p = <0.01). Most participants (n =212; 76%) indicated that they were not receiving
continuing education, with the registered nurses more likely to disagree (÷² test, p = 0.02).
Participants in both hospital types A (n = 131; 82%) and B (n = 108; 91%) also disagreed that
provision of equipment and consumables was adequate.
The research showed that inadequacies relating to human resources, professional development,
consumables and equipment influenced the quality of patient care. Urgent attention should be
given to the problems identified to ensure quality of patient care in rural hospitals.